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Internal Medicine > Week 1- Intro and Epigenetics > Flashcards

Week 1- Intro and Epigenetics Flashcards

1
Q

Gender and sex differences are topics with constantly updating information. Recent research has indicated that steroid-induced epigenetic changes impact a single life span. Which of the following may exert a multigenerational effect?

-lacrimal disrupting compounds
-mammary disrupting compounds
-endocrine disrupting compounds
-exocrine disrupting compounds

A

endocrine disrupting compounds

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2
Q

Based on the case study 45 Parkinson Disease, which of the following facts belong to the component of body structures/functions on the ICF framework?

-During the day, he will often sit in his chair staring at the television for hours, often not moving.
-His tremors have become less pronounced during the last three weeks.
-The family will often play cribbage with him and are very patient as E. slowly lays down his cards and pegs his points.
-He is always happy to see the children, even smiles when they visit with him.

A

His tremors have become less pronounced during the last three weeks.

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3
Q

Based on the case study 45 Parkinson Disease, which of the following facts belong to the personal factor on the ICF framework?

-Hoehn and Yahr Staging of Parkinson Disease: Stage 4.
-Poor postural stability and poor fine motor coordination.
-He is always happy to see the children, even smiles when they visit with him.
-Relocated after his wife’s death and now living with family of four in Wyoming; mother/ wife of family is LPN and caregiver in the home.

A

Relocated after his wife’s death and now living with family of four in Wyoming; mother/ wife of family is LPN and caregiver in the home.

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4
Q

What is defined as the development of unhealthy conditions or disease?
-Pathology
-Pathogenesis
-Physiology
-Clinical pathology

A

Pathogenesis

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5
Q

The World Health Organization (WHO) defines which of the following as “a state of complete physical, mental, and social well-being, and not merely as the absence of disease or infirmity”?
-Health
-Well being
-Biologic state
-Psychologic state

A

Health

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6
Q

Which of the following is the correct term used to describe a medical condition that is substantiated by objective data such as elevated temperature or presence of infection?
-Sickness
-Pathology
-Illness
-Disease

A

Disease

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7
Q

If an individual has experienced brain damage that leads to decreased executive function, what area of the brain is most likely injured?
-Left hemisphere
-Temporal lobe
-Occipital lobe
-Right hemisphere

A

Right hemisphere

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8
Q

Who created the germ theory?
-Marie Curie
-Charles Darwin
-Louis Pasteur
-John Harrison

A

Louis Pasteur

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9
Q

Who made a ground-breaking study of mitochondrial DNA in the beginning of the 21st century?
-Douglas Wallace
-Francis Crick
-Lois Pasteur
-James Watson

A

Douglas Wallace

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10
Q

Which is not a primary prevention strategy?
-Immunization
-Seatbelts
-Helmets
-Antibiotics

A

Antibiotics

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11
Q

When did the Human Genome Project start?
-1990
-1969
-1979
-2000

A

1990

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12
Q

Which century has brought a better understanding of the biopsychosocial-spiritual variables that affect healthcare?
-21st
-20th
-19th
-18th

A

21st

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13
Q

The number one cause of death in the U.S. adult population, heart disease, has been reduced by how much due to changes in diet and lifestyle.
-52%
-90%
-25%
-10%

A

52%

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14
Q

Which of the following is NOT an example of a damage-based explanation of aging?
-Wear and tear theory
-Error theory
-Telomerase theory
-Free radical theory

A

Telomerase theory

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15
Q

Adverse childhood experiences are linked to problems in adulthood including all except
-Travel related disease
-Autoimmune disorders
-Fibromyalgia
-Addiction to tobacco, drugs, or alcohol

A

Travel related disease

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16
Q

Who are examples of successful aging?
-40s
-100s
-20s
-80s

A

Those in their 100s

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17
Q

Past schools of thought indicated that race was the cause of health disparities, while current thinking indicates that epigenetics is more likely the cause and include interactions between all except the following:

-Specific sociocultural and health behaviors
-The amount of melanin in skin
-Environmental factors
-Genetic variations

A

The amount of melanin in skin

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18
Q

Life expectancy in the 20th century has increased by 35 yrs. Healthcare improvements have created an additional how many years of that 35?
-25 yrs
-7 yrs
-2 yrs
-5 yrs

A

7 yrs

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19
Q

What group as seen the most rapid population increase in the past decade?

-Baby boomers
-Middle aged
-Over age 85
-Newborns

A

Over age 85

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20
Q

Supercenturians live to be over how many years past 100?

-5 years
-10 years
-2 years
-7 years

A

10 years

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21
Q

The branch of medicine that investigates the essential nature of disease, especially changes in body tissues and organs that cause or are caused by disease

A

Pathology

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22
Q

Pathology applied to the solution of clinical problems

A

Clinical pathology

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23
Q

According to the annual report “Health, United States, 2017”, what are the most common causes of morbidity and mortality?

A

-Obesity
-Alcoholism
-Drug abuse
-Tobacco use

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24
Q

What is often used to describe the health status of a nation?

A

Leading causes of death

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25
Q

True or False: The health of an individual is more accurately viewed as a reflection of a person’s biologic, psychologic, emotional, spiritual, and sociological state.

A

True

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26
Q

Health is a dynamic process that varies with changes in __________.

A

Interactions between an individual and internal/external environment

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27
Q

What is defined as “sickness or deviation from a healthy state”?

A

Illness

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28
Q

This term refers to a biologic or psychologic alteration that results in a malfunction of a body organ or system.

A

Disease

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29
Q

This term is known as the perception and response of the person to not being well.

A

Illness

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30
Q

It includes disturbances in normal human biologic function and personal, interpersonal, and cultural reactions to disease.

A

Illness

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31
Q

True or false: Disease can occur in an individual without the person being aware of illness and without others perceiving illness.

A

True

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32
Q

True or false: A person can feel very ill even though no obvious pathologic processes can be identified.

A

True

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33
Q

This term usually refers to an illness or disease that has a relatively rapid onset and short duration. The condition often responds to a specific treatment and is usually self-limiting.

A

Acute illness

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34
Q

True or False: If no complications occur, most acute illnesses do not end in a full recovery and individual cannot return to previous levels of functioning

A

False

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35
Q

This term describes illnesses that include one or more of the following characteristics: permanent impairment or disability, residual physical or cognitive disability, or the need for special rehabilitation and/or long-term medical management.

A

Chronic illness

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36
Q

What are some characteristics of chronic illness?

A

-Permanent impairment or disability
-Residual physical or cognitive disability
-The need for special rehabilitation and/or long term management

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37
Q

Many chronic illnesses are modifiable through ______.

A

Changes in behavior and lifestyle

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38
Q

One of the most important factors that influence psychological reactions to illness

A

Premorbid (before illness) personality and psychologic profile

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39
Q

Name three premorbid personalities.

A

-Dependent
-Narcissistic
-Stoic

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40
Q

Someone with this personality may seek unusually large amounts of advice or reassurance from health care specialist or expect attention beyond that required for the degree of illness present.

A

Dependent

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41
Q

Someone with this personality may be particularly concerned about the need to take medication or the loss of the ability to work

A

Narcissistic

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42
Q

Someone with this personality may have difficulty admitting to being sick at all.

A

Stoic (indifferent to or unaffected by pain)

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43
Q

What are common reactions to illness?

A

-Fear/anxiety related to the loss of control over one’s own body
-Denial

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44
Q

An unconscious defense mechanism that allows a person to avoid painful reality as long as possible. It can be a natural part of the process of dealing with illness and culminate into acceptance.

A

Denial

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45
Q

Why is it important to consider the whole person in treating an individual?

A

There may be multiple variables that influence the health and illness of an individual.

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46
Q

Why is pathology important to a PT?

A

We need to know:
-The effects of pathologic process on the person’s FUNCTIONAL ABILITILES/LIMITATIONS and the role of EPIGENETICS
-How a person can participate in his/her family and community

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47
Q

In 2016, what percentage of the U.S. population lived with a disability?

A

25%

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48
Q

Cortical functions involved in formulating goals and planning, initiating, monitoring, and maintaining behavior

A

Executive functions

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49
Q

Overt motor, affective, and social are included in this term

A

Behavior

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50
Q

The effective handling of new information

A

Complex problem solving

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51
Q

The speed at which information travels from one part of the brain to another

A

Information processing

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52
Q

What do memory deficits result from?

A

Failure to store or retrieve information

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53
Q

Term that describes difficulty acquiring information in specific domains (ex: spelling, arithmetic, reading, and visual-spatial relationships) in a person with normal or near-normal intelligence

A

Learning disability

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54
Q

What is the framework used by the World Health Organization (WHO) to classify and code information about health and provide standard language?

A

International Classification of Functioning, Disability, and Health (ICF)

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55
Q

What are six components of the ICF?

A

-Body structures/functions
-Activities
-Participation
-Environmental factors
-Personal factors
-Health conditions

BHAPPE

56
Q

Defined as physiologic or psychologic functions of body systems or parts. Impairments are included. (ICF)

A

Body functions/structures

57
Q

The execution of specific tasks (ICF)

A

Activity

58
Q

Difficulties a person might have in executing activities

A

Activity limitations

59
Q

The individual’s involvement in life situations.

A

Participation

60
Q

This occurs when cells or tissues have been required to adapt beyond their limitations

A

Injury

61
Q

What is the result of an imbalance in the ability of the body (cell) to regulate the internal environment?

A

Illness

62
Q

This theory suggests that stress causes disease by placing excessive demands on the body, which in turn produces high levels of adaptive hormones, influencing the inflammatory process and regulation of metabolism.

A

Homeostasis theory

63
Q

The study of interactions among behavior and neural, endocrine, enteric, and immune system functions

A

Psychoneuroimmunology

64
Q

This theory outlined the influence of the nervous system on immune and inflammatory responses and how the immune system communicates with the neuroendocrine system.

A

Psychoneuroimmunology

65
Q

The integration of the hypothalamic-pituitary-adrenal axis and the neuro-endocrine-enteric axis has a biologic basis first discovered in the late __________.

A

1990s

66
Q

True or false: The digestive system is considered a part of the neurologic system along with the brain, spinal cord, and peripheral nerves.

A

True

67
Q

This directs us to see the human form as a dynamic and every-changing energy field that creates, influences, and potentially enhances our health status.

A

The Quantum Model of Health and Disease

68
Q

The way that people perceive and shape their reality or, in other words, their sense of awareness or being

A

Consciousness

69
Q

This model allows for the inner wisdom of both patients and health care providers to be combined with scientific and technologic advances for the promotion of health and well-being.

A

Consciousness-Based Health Care

70
Q

These diseases are also called lifestyle or chronic diseases.

A

Noncommunicable diseases

71
Q

Heart disease, stroke, cancer, diabetes, and lung disease are known as __________.

A

Noncommunicable diseases

72
Q

Risk factors/behaviors associated with noncommunicable disease

A

Physical inactivity, unhealthy diet, tobacco use

73
Q

How can physical therapists reduce risk factors, prevent, and treat noncommunicable diseases?

A

-Providing patient and client education
-Prescribing physical activity and exercise
-Performing noninvasive, hands-on interventions consistent with biopsychosocial paradigm

74
Q

This is built on the principles of self-responsibility, nutritional awareness, stress reduction and management, and physical activity and exercising.

A

Health promotion

75
Q

Categories of preventive medicine

A

-Primary
-Secondary
-Tertiary

76
Q

This type of prevention gears toward removing/reducing disease risk factors.

A

Primary prevention

77
Q

Good nutrition, using seatbelts, wearing helmets, and immunizations are examples of this prevention.

A

Primary prevention

78
Q

This type of prevention promotes early detection of disease and employs preventative measures to avoid further complications.

A

Secondary prevention

79
Q

Skin tests for TB, mammography, colonoscopy, and Pap smears are examples of this prevention.

A

Secondary prevention

80
Q

This type of prevention aims at the limiting impact of the established disease.

A

Tertiary prevention

81
Q

Radiation and chemotherapy are examples of this prevention.

A

Tertiary prevention

82
Q

This prevention involves rehabilitation, in which the goal is to return the person to the highest possible level of functioning.

A

Tertiary prevention

83
Q

True or False: Most adults with disabilities cannot participate in physical activity

A

False

84
Q

True or False: Sequence differences among individuals may be associated with health and disease.

A

True

85
Q

Variation in the genome can be considered under three main categories:

A

-Changes in single base pairs
-Insertion/deletions of a small or large number of base pairs
-Structural rearrangements on a chromosome

86
Q

From 1990-2003, it’s intention was to map and sequence the entire human genome, along with model organisms such as the mouse.

A

Human Genome Project

87
Q

An approach in which prevention and intervention strategies are tailored to the individual based on their genomic/cellular information, environment, activities, behavior, and social networks.

A

Precision medicine

88
Q

Personalized rehabilitation programs based on DNA sequence variation

A

Exercise genomics

89
Q

What are genetic factors in precision PT associated with?

A

-Disease risk
-Severity and progression of disease
-Variation in response to exercise and rehabilitation programs

90
Q

What are the levels of organization in an organism?

A
  1. Atom
  2. Molecule
  3. Macromolecules
  4. Organelle
  5. Cell
  6. Tissue
  7. Organ
  8. Organ System
  9. Organism
91
Q

This term defines the study of how biologic (internal) and environmental (external) signals determine gene expression

A

Epigenetics

92
Q

Epigenetic signs can prompt changes in the __________ attached to a gene, turning it on or off.

A

Methyl chemical groups

93
Q

The blueprint that directs the gene to put together the building blocks that produce proteins, the basis of our human physiologic form and structure.

A

DNA

94
Q

True or False: DNA does not change. The expression of DNA and the reading of the gene can change.

A

True

95
Q

How does epigenetics help reflect on yourself

A

We can recognize how our internal and external environments impact and influence health

96
Q

The physical environment is often divided between the ______________ and _____________.

A
  • built environment (buildings and park spaces where people live, work, and recreate)
    -natural/physical environment (air, water, soil/rock, sun)
97
Q

This term defines the interaction of attitudes, thoughts, emotions, feelings, beliefs, and reactions/responses to events that directly affect our physiological function.

A

Internal environment

98
Q

What happen when automatic negative thoughts (repetitive thoughts, images, and ideas) are left unchallenged?

A

They take over the person’s thoughts and increase the levels of stress hormones circulating through the body.

99
Q

When stress is ongoing, what happens to the cells of the immune system?

A

Cells of the immune system become insensitive to cortisol, resulting in unchecked inflammation, which is a major force in the development of many chronic conditions, disease, and autoimmune disorders.

100
Q

This includes variables such as air, water, food, toxins, a person’s social network, community, sense of purpose in life, and spiritual beliefs.

A

External environment

101
Q

According to WHO, what risk factors attribute to the highest number of deaths?

A

-High blood pressure
-Tobacco use
-High blood glucose
-Physical inactivity
-Overweight and obesity
-High cholesterol

102
Q

More than half of deaths from the leading causes in the U.S. are associated with __________.

A

Behavioral lifestyle factors (ex: diet, exercise, smoking, substance abuse)

103
Q

What are some aspects geography play a role in epigenetics?

A

-Community
-Geographic/political climates
-Treatment for a single medical condition can vary significantly from one location to another (ex: surgical procedures, healthcare system, physician/hospital preferences)

104
Q

What is the most adverse influence on health?

A

Socioeconomic status

105
Q

True or False: Differences in attitudes toward health have been found to be greater between races/ethnic groups than social classes.

A

False

106
Q

What is the fastest growing population in need of healthcare?

A

Homeless and unsheltered people

107
Q

What are contributing factors to the rise in homelessness?

A

-Decline of public assistance
-Shortage of affordable rental housing
-Increase in poverty

108
Q

This term is defined as differences in individual or regional community health owing to lack of access, high cost, or other factors that create barriers to health services.

A

Health disparities

109
Q

True or False: Health across the life span is strongly affected by social disadvantage.

A

True

110
Q

This term refers to the web of social relationships that link us together.

A

Social network

111
Q

Impact on health of social network is a __________.

A

Continuum of factors (cultural, socioeconomic, political, religious, geographic, psychologic)

112
Q

What are social structural conditions that can exert a negative influence on health?

A

-Poverty
-Discrimination
-Conflict

113
Q

This is affected by food supply trends, nutritional content of foods, larger portion sizes, availability of fast food items, and eating away from home regularly

A

Eating behavior

114
Q

What are some environmental barriers to health care?

A

-Eating behavior
-Grocery store proximity and fresh food availability
-Exposure to art, architecture, and music
-Incentives to exercise

115
Q

True or False: The environment in which family members are raised may contribute
to how genetic traits are stimulated to express the disease or condition carried by the gene.

A

True

116
Q

This term describes how behavior must be judged first in relation to the context of the culture in which it occurs.

A

Cultural relativity

117
Q

True or False: Cultural factors do not prevent illness.

A

False

118
Q

This requires a multidimensional approach that takes into account the current era of globalization and migration and their impact on health beliefs, disparities, and diversity within ethnic groups

A

Transnational competence

119
Q

It is estimated that ___% of the U.S. adult population will be exposed to at least one trauma event in their life.

A

50-60%

120
Q

This term refers to the physical differences that groups and cultures consider socially significant.

A

Race

121
Q

This term refers to shared culture, such as language, ancestry, practices, and beliefs.

A

Ethnicity

122
Q

This term refers to a social construct defined as person’s own understanding of sexual identity

A

Gender

123
Q

True or False: Sexual orientation and gender identity questions are not asked on most national or State surveys, making it difficult to estimate the number of LGBT individuals and their health needs.

A

True

124
Q

The idea that epigenetic modifications accumulated throughout the entire life span can cross the border of generations and be inherited by children or even grandchildren

A

Transgenerational epigenetics

125
Q

A complex multifactorial biologic process characterized by a gradual decline of physiologic functions in a predictable pattern over time

A

Aging

126
Q

The process or condition of growing old

A

Senescence

127
Q

Term to describe that aging is regulated by a biologic clock

A

Programmed-based

128
Q

This theory states that the shortening of telomeres in the process of DNA replication during cell division determines how long a cell functions and when cellular apoptosis occurs.

A

Telomerase theory

129
Q

What are a few examples of problems physical therapists will treat in older clients?

A

-Confusion
-Fractures and other injuries related to falls
-Strokes
-Infections
-Inappropriate medications
-Decline in drug clearance

130
Q

True or False: Lifestyle factors and other environmental influences do not alter our life span by changing the epigenetic information.

A

False

131
Q

Examples of environmentally induced damage include:

A

-alterations to DNA
-formation of free radicals
-increased cross-linking of tendon, bone, and muscle tissue

132
Q

Of all the epigenetic environmental factors, which are most likely to top the list in terms of importance and impact on the gene?

A

Diet and nutrition

133
Q

This disease is also linked to other costly chronic diseases such as insulin resistance, type 2 diabetes, fatty liver disease, endocrine and immune disorders, and cardiovascular disease.

A

Obesity

134
Q

True or false: Many epigenetic studies involving physical activity and exercise interventions do not have a clear benefit to chronic diseases such as metabolic syndrome, diabetes, cancer, cardiovascular disease, and neurodegenerative disease.

A

False

135
Q

True or False: The use of substances such as tobacco, alcohol, and other drugs can relate to stress, trauma, and addictions.

A

True

Internal Medicine (25 decks)

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